metastatic cancer in lungs

tootsieholic

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Hello, I'm here to seek a few opinions.

My neutered, DSH, soon to be 12 yr old cat has either fibrosarcoma or osteosarcoma in the hind leg.  Xrays showed osteolytic lesions in the bone and a large soft tissue mass surrounding it.  Blood work is completely normal - not a single value out of range.  Before scheduling amputation, we had chest xrays done which showed some abnormalities that the vet thought was mild asthma.  The radiologist's report however, said that there were few nodules which looked consistent with metastatic disease.  This radiologist report sucked.  It didn't say how many nodules or where they were or what size we they were.  Anyways, the vet was really against amputation at this point, so...

I sought a second opinion from another vet who was highly recommended by coworkers.  He looked at the initial chest xrays and pointed out one nodule and said that there is a realistic chance that it could be age related spot.  He suggested a repeat xrays 2 weeks later so we did.  When the second vet looked at the new xray, he felt that there was no change.  However, radiologist report came back saying that there are multiple nodules (doesn't say how many) consistent with metastatic cancer and concluded that amputation would be an option if in conjunction with chemo.  At least one of these nodules are 6 mm, and one 8 mm.  Second vet advised against amputation but will do it if I request it.  With the shock I was going through, I did not ask whether the radiologist compared the xray to the original chest xray.  This is something I will discuss further with the vet.

The first vet was overly optimistic and between fluid biopsy, antibiotics, NSAIDs, two weeks have gone by since I first found the lump and the first set of xrays.  As of today, it's been 1 mo and 4 days since I origially found the lump size of golf ball split in half.  Now it's a size of child's fist located in the inner aspect of the leg

So naturally, what does a prudent cat owner do?  She turns to google and find that there is very little information on cats living with metastatic lung cancer.  There's so little statistics on the matter that I hope some of you can share your experiences.

The dilemma is whether I should put my cat to sleep now, or

Amputate the leg as part of "palliative care" since he is barely using it at this point and who knows how long it would be before lung mets will start showing symptoms.  After that he'll probably go on prednisone.  I may pursue chemo as well, depending on the oncologist's suggestion after a definitive CA diagnosis is reached.

I cannot do the "do nothing but prednisone" route as he is barely using the leg now.  I mean, he's cute in any position and I don't love him any less for it, but #1 problem with this is that he doesn't get up to eat on his own when I'm not home.  He's always been a grazer.  He eats as much as he always did when I bring food to him.  The problem is that I'm the only human in the house and with my job as a nurse, sometimes I can't get home early enough to get adequate calories in him.  With his brother, this kind of eating habit would be completely abnormal, but with this cat, this is not far from his norm.  I can get more calories in if I syringe feed but ya know, cats hate it.  I really don't see anything palliative about this option  where all my interaction with the cat is turning into getting calories in while his painful leg stays and continues to get worse.  Besides the eating and reluctance to walk, there's really no change in his demeanor.  He's using the litter box, he comes to greet me at the door and follows me around a bit, then he sits somewhere where he can see me.  And that's completely normal for him as he's always been a placid cat.  At the most recent vet visit, he has gained back some weight.  Putting him to sleep is such a hard decision to make.  I feel like he'd be okay with the amputation since he's barely using his leg now.  There's really nothing else wrong with him at the moment except for a completely asymptomatic cancer in the lung.

So I'm hoping if anyone has any opinions they'd be willing to share with me.  My major concerns are:

- If you've had an oncology consultation regarding the issue, what has been said?  The new vet will refer me to Cornell but he feels that it may not be worth it as I will only receive "textbook" answers at this point; that chemo on lung CA is often unsuccessful.  Besides, without knowing what cancer cells we're dealing with, they might not even be able to give me a prognosis without further diagnostic tests. 

- For cats with metastatic lung cancers, how long did it take before your cat started to have breathing issues?  Did prednisone buy more quality time?

- Did you have time to arrange for a euthanasia with lung cancer or was the decline real sudden?  How long did they live?

- Any experience treating it with chemo?

- If your cat had an amputation, how long did it take for him to eat on his own and start using his litterbox (hind leg amputees)

Finally, what would you do?  He is exclusively an indoor cat with no health issues except for the leg & associated weight loss (14 lbs would be most ideal for him, he's down to 11.6). 
 

stephanietx

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I wish I had some words of wisdom for you, but I don't. I'm sorry you're having to go through this, though.
 

mrsgreenjeens

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Gosh, that's a tough one
  You asked what I would do.  I will tell you that it entirely depends on which cat of mine this happened to.  One of mine has such a jest for life that there is no question I would go for it and have the surgery and take it from there. At least he'd have a chance, because from what it sounds like, without the amputation, he's not got much of one.  And since you don't really know if he has lung cancer or not, to me it would be worth it...with my cat with the jest for life.  BUT, if it were my other cat, I might NOT do it.  He's just a completely different cat and I'm not sure HE would want to have it done


As far as how quickly they go downhill IF they actually do have lung cancer, we do have a couple of threads on that, and they will have trouble breathing once it starts in.  Usually it goes pretty quickly after that. Say a week or so is what I recall.

Here is a recent thread:  http://www.thecatsite.com/t/333514/lung-cancer

 
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